DIZZINESS IN OLDER PEOPLE

头晕和身体不平衡在老年人中很常见，但往往很难确定原因。相关的福尔斯和对跌倒的恐惧影响了他们的生活质量，限制了他们的日常活动。我们假设头晕和平衡失调不是正常衰老的结果，而是涉及内耳和大脑的特定病理生理变化的结果。我们的目标是更好地了解老年人头晕和身体不平衡的原因。我们建议继续对主诉头晕和平衡失调的患者和年龄匹配的对照组进行纵向研究，每年进行一次检查，包括定量视觉前庭测试和姿势描记。第一个具体目标的目标是：a）记录与正常衰老相关的前庭功能和平衡的变化; B）定义老年人头晕和平衡失调常见原因的自然史;以及c）记录不明原因头晕和平衡失调患者的临床病程。第二个目的是将正常受试者和进行尸检的患者的功能与形态相关联，目的是解释内耳和大脑内可识别变化的平衡变化。临床诊断的准确性如何？不明原因的头晕和平衡失调患者是否表现出与年龄匹配的对照组不同的内耳或大脑变化？本研究的独特之处在于：a）纵向设计; B）尸检时的组织病理学发现与生前获得的定量试验信息结果之间的相关性。以前很少有关于老年人头晕和失衡的纵向研究，也没有包括听觉和前庭功能的系列测量，平衡的定量测量，半定量神经学检查和大脑的系列磁共振成像（MRI）。先前的组织病理学研究在老年人的平衡功能障碍集中在颞骨或大脑，但不是两者，缺乏详细的临床数据，很少有包含定量信息的前庭功能在生活中。通过继续对仔细研究的老年患者和对照组进行纵向研究，我们的多学科研究团队能够很好地实现我们的目标。

Complaints of dizziness and disequilibrium are common in older people yet it is often difficult to determine the cause. Associated falls and fear of falling affect the quality of their lives and limit their daily activities. We hypothesize that dizziness and disequilibrium are not a result of normal aging but rather the result of specific pathophysiologic changes involving the inner ear and brain. Our goal is to better understand the causes of dizziness and disequilibrium in older people. We propose to continue a longitudinal study of patients complaining of dizziness and disequilibrium and age-matched controls with yearly examinations including quantitative visual-vestibular testing and posturography. The goal of the first specific aim is to a) document changes in vestibular function and balance associated with normal aging; b) define the natural history of the common causes of dizziness and disequilibrium in older people; and c) document the clinical course in patients with dizziness and disequilibrium of unknown cause. The second aim is to correlate function with morphology in normal subjects and patients who come to postmortem examination with the goal of explaining changes in balance in terms of identifiable changes within the inner ear and brain. How accurate were the clinical diagnoses? Do patients with dizziness and disequilibrium of unknown cause show changes in the inner ear or brain different from those of age-matched controls? The unique features of this research are a) the longitudinal design and b) the correlation of histopathologic findings at the time of postmortem examination with the results of quantitative test information obtained during life. There have been few prior longitudinal studies of dizziness and imbalance in older people and none that includes serial measurements of auditory and vestibular function, and quantitative measurements of balance, semiquantitative neuro-logical examinations and serial magnetic resonance images (MRI's) of the brain. Prior histopathological studies in older people with balance dysfunction have focused on the temporal bone or brain but not both, have lacked detailed clinical data, and rarely have contained quantitative information regarding vestibular function during life. By continuing this longitudinal study of carefully studied older patients and controls, our multidisciplinary research team is in a good position to achieve our goals.